Drugs that Don’t Help Could Hurt

Physicians continue to overprescribe antibiotics for patients with sore throats, a study finds.

By Tracy Vence | October 4, 2013

WIKIMEDIA, SHORELANDERSeeking relief from their acute bronchitis and sore throat symptoms, many patients pay visits to their doctors, who often prescribe antibiotics. But not all patients experiencing symptoms of bronchitis and sore throat benefit from the drugs. And according to a study published this week (October 3) in JAMA Internal Medicine, physicians who prescribe antibiotics even when they might not help may be contributing to the growing problem of drug-resistance.

“We know that antibiotic prescribing, particularly to patients who are not likely to benefit from it, increases the prevalence of antibiotic-resistant bacteria, a growing concern both here in the United States and around the world,” study coauthor Jeffrey Linder, a physician-researcher at Brigham and Women’s Hospital in Boston, said in a statement. Analyzing records from primary-care and emergency-department visits, Linder and his colleague Michael Barnett found that the national prescribing rate for adults with sore throat held steady at around 60 percent from 1997 to 2010. But only around 10 percent of adults with sore throat are infected with group A Streptococcus—the only common cause of the symptom requiring antibiotics. Meanwhile, “for acute bronchitis, the right antibiotic prescribing rate should be near zero percent, and the national antibiotic prescribing rate was 73 percent,” Linder said.

Public health officials have for years warned about the perils of overprescribing antibiotics. But according to Linder and Barnett’s analysis, not much has changed.

As CNN’s The Chart blog noted, patients are part of the antibiotic problem, often demanding drugs when they feel sick. “I think there’s a discussion that should be happening between patient and doctor that doesn’t happen, that automatically leads to an antibiotic prescription,” Linder told CNN.

According to MedPage Today, Linder told reporters at the IDWeek meeting being held in San Francisco this week that physicians must push back, citing the rising threat of drug-resistant bacteria. “For individual patients, the compelling reason not to take antibiotics is they’re not going to help you and there’s a very real chance they’re going to hurt you,” he said.

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One of the major movers in this is not over prescribing, but the local sewer plant. The US/EPA did a study back in the late 1970s that showed that the nation's sewer plants were a principal source of antibiotic resistant organisms added to the aquatic environments. Thus that sewer plant up-river is not only dumping industrial volumes of multi-antibiotic resistant organisms into that river, but by its current design and processing, aided by antiquated standards, is actually generating them. These organisms and importantly their genes (antibiotic resistant genes) are now being found in drinking water whose raw stock source was river water. The US/EPA report was removed by the agency and there are no traces of it in the agency's data base according to the library contractors for EPA. Many of us have asked why such a critical paper missing? Those in the know say it is because the agency is and has been promoting the reuse of sewage byproducts in agriculture and it would not look good to be promoting something that spread antibiotic resistance.

There are new papers confirming what the early EPA paper noted. Additionally, the CDC has come out recently with reports that we are up against critical levels of antibiotic resistant organisms while at the same time running out of viable antibiotics. What's next, Civil War amputations for infected limbs?

It is time to stop the politically correct shielding of polluting industries by EPA. We have precious little wiggle room left.